在老年人群中进行全面的保守性管理:全国行政索赔数据库分析
Arisa Kobayashi1,2, Keita Hirano1, Tadahisa Okuda1,3
1Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kidney360
|July 22, 2025
概括
保守性管理 (CKM) 对于患有晚期慢性病 (CKD) 的老年人来说是一个可行的选择. 与脏替代疗法 (RRT) 相比,这种方法导致住院次减少,但没有影响存活率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 保守性管理 (CKM) 是对晚期慢性病 (CKD) 的老年患者的替代疗法 (RRT) 的替代方案.
- 关于CKM选择和老龄化人口的结果的证据有限.
- 这项研究比较了晚期CKD的日本老年人中CKM和RRT之间的住院和生存率.
研究的目的:
- 为了比较保守管理 (CKM) 和替代疗法 (RRT) 之间的住院和生存率.
- 确定影响晚期慢性病 (CKD) 的老年人CKM选择的因素.
主要方法:
- 对75岁以上的个人,其eGFR<8mL/min/1.73m2.2的大型行政索赔数据库的分析.
- 将患者分为CKM (没有RRT程序) 和非CKM (RRT程序) 组.
- 用于评估CKM选择,生存和住院率的Cox和Poisson回归模型.
主要成果:
- 428名患者中有307名 (71.7%) 属于CKM组;CKM在非脆弱个体中更为常见.
- 而CKM组的住院率明显较低 (调整后的IRR为0.40).
- 在CKM和非CKM组之间,死亡率没有显著差异 (HR 0.84).
结论:
- 慢性瘤管理经常被高级慢性瘤的非脆弱患者选择.
- 与RRT相比,CKM与住院减少和相似的生存率有关.
- 需要进一步的研究,以优化对老龄化人口的CKM指示.
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